What Causes Hemiplegic Migraine Headaches?

Researchers have now identified three genes linked with hemiplegic migraine.

The three genes linked with hemiplegic migraine are the CACNA1A, ATP1A2, and SCN1A genes. Defects, or mutations, in any of these three genes lead to a breakdown in the body's ability to make a certain protein. That protein is needed for clear communication among nerve cells. Without that protein, nerve cells have trouble releasing or taking up neurotransmitters -- the chemical messengers between nerve cells.

Most people with hemiplegic migraine have inherited the gene mutation from one parent who also had the condition.

What Medical Tests Are Used to Diagnose Hemiplegic Migraine Headaches?

If you have any of the symptoms of hemiplegic migraine, see your doctor for a full evaluation. This is a serious form of migraine and many of its symptoms are also signs of a stroke. Tests to look for signs of a stroke may include a CT scan or MRI of the head. An exam may also include tests of the heart and blood vessels in your neck to evaluate whether your symptoms may be caused by blood clots forming in the heart or blood vessels in the neck.

Genetic testing is available for hemiplegic migraine. If you have a family member with similar symptoms, or if you test positive for one of the genetic defects linked to hemiplegic migraine, you maybe diagnosed with "familial" hemiplegic migraine. That means it runs in your family, and you most likely could pass it on to your children. If you don't test positive, your condition is called sporadic hemiplegic migraine.

How Are Hemiplegic Migraine Headaches Treated?

There is disagreement over how to treat hemiplegic migraines. There is also disagreement about the safety and effectiveness of standard migraine medications. Many doctors are feeling more comfortable using triptans in the treatment of hemiplegic migraines. But your doctor may prescribe other medications to treat severe attacks and prevent future episodes. Treatment may include:

Preventive medications. Your doctor may prescribe an anticonvulsant medication or calcium channel blocker to help reduce the number and severity of future attacks.

Acute medications. As noted above, many physicians now use triptans in the treatment of an acute attack.